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  #1  
Old 01-08-2013
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ObGyn Cervical Ectropion ?

A 22-year-old woman presents with a chief complaint of a foul-smelling vaginal discharge. It began 2 days ago, and has not responded to bathing or douching. She has been in a mutually monogamous relationship for the past 6 months with one male partner. She uses combination oral contraceptives reliably. Her past medical history is unremarkable, and she takes no other meds. On examination, her external genitalia appear erythematous, but without focal lesions or ulcerations. Inserting the speculum, you see a frothy yellow green discharge coating the blades. Her cervix appears to have an ectropion. A wet mount examination shows many squamous epithelial cells with adherent cocco-bacillary organisms. What is best treatment for this condition?

A. A cone biopsy of the cervix
B. Clotrimazole vaginally
C. Metronidazole intravaginally
D. Metronidazole orally
E. Vinegar and water douche
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Old 01-08-2013
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D. single dose metronidazole orally.
even though she has cervical ectropion, it doesnt need treatment unless it is symptomatic(which would be post coital bleeding). it could be caused due to her ocp's. here she has trichomoniasis which is causing the symptoms.
douching is anyways wrong. neither she or the doc is suppose to do it. clotrimazole is topical, not used here.

my question is does cervical ectropion cause cervical cancer in the long run???
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Old 01-08-2013
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Cervical ectropion has neither been linked to cancer nor it is a pre-cancerious lesion....But ectropion may be clinically indistinguishable from early cervical cancer, hence a pap smear/biopsy are need for differentiation.
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Old 01-08-2013
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D. Metronidazole orally
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